Pharmacists Can Help Patients Treat Digestive Disorders

The digestive system is made up of the gastrointestinal (GI) tract, along with solid organs, including the gall bladder, liver, and pancreas. The GI tract is a series of hollow organs joined by a long, twisted tube leading from the mouth to the anus. These hollow organs also include the mouth, esophagus, large and small intestines, and the stomach.¹

The gut flora and part of the circulatory and nervous systems all play a role in digestion. Working with the organs, blood, gut flora, hormones, and nerves aid the process of digesting the macronutrients taken into the body, transforming them into micronutrients that can be absorbed and used for cell repair, energy, and growth.¹

The body needs nutrients to maintain overall health. Carbohydrates, fats, minerals, proteins, vitamins, and water are all necessary nutrients. Carbohydrates are broken down into simple sugars, fats are broken down into fatty acids and glycerol, and proteins are broken down into amino acids.¹

Disorders of the digestive tract are common and can range from simple to severe. Poor digestive health can cause uncomfortable symptoms, such as abdominal pain, bloating, and indigestion. It can also disturb proper nutritional absorption.

TIPS FOR A HEALTHY DIGESTIVE SYSTEM

• Use prebiotics and probiotics. The balance of microorganisms that live in the digestive tract is an intricate network of metabolic interdependence. These microorganisms consist of bacteria, viruses, and yeasts. The right balance of these microorganisms is vital for immunity and mental and physical health. Prebiotics and probiotics are available in foods and supplements and may help improve gut health. Prebiotics provide nutrients meant to promote the growth of beneficial gut flora, whereas probiotics contain live cultures of good flora.² Prebiotics are special plant fibers found in apples, bananas, and chicory. Probiotics are found in kimchi, kombucha, sauerkraut, and yogurt.
• Eat fermented foods. Fermentation is a process that involves bacteria and yeast breaking down sugars. Fermentation increases shelf life and can boost the number of helpful bacteria in the gut. All fermented foods are not created equal. Only naturally fermented foods have active probiotics that provide this beneficial effect. Make sure the label says “naturally fermented” and look for bubbles in the liquid when opening the bottle. This signals that live organisms live inside. Some examples include kefir, miso, natto, and tempeh.
• Lower stress levels. Stress can affect every part of the digestive system. Hundreds of millions of neurons in the gut communicate with the brain. Stress can affect this communication. Stress can also disturb the microbiome, thereby affecting the brain, emotion, and thought.³
• Avoid unnecessary antibiotic use. Gut flora is vital for normal functioning of the human body. Although antibiotic use is sometimes necessary, it can have several negative effects on the gut microbiome. It can alter metabolic activity, reduce the diversity of microorganisms, and select for antibiotic-resistant organisms.
• Get good sleep. Studies have shown that the gut microbiome regulates host sleep and mental states, as well as affecting the digestive, immune, and metabolic functions through the microbiome-gut-brain axis. This suggests that gut microbiomes and metabolism are related to the host’s circadian rhythm and sleep.⁴
• Do not smoke. Research has shown that quitting smoking leads to changes in the gut microbiome. Improved bacterial diversity was shown after participants quit smoking. These changes resulted in reductions in C-reactive proteins, heart rate, and systolic blood pressure, indicating the vast effects that gut health has on the body as a whole.⁵
• Stay hydrated. Drinking plenty of water has beneficial effects on the mucosal lining of the intestines. It also benefits the balance of the gut flora.2 Water helps break down food, allowing nutrients to be absorbed by the large and small intestines.
• Change the diet. In addition to reducing processed foods and refined sugar intake, other dietary changes can be beneficial. Eat a diet high in fiber, including asparagus, bananas, beans, berries, leeks, legumes, oats, peas, and whole grains. When gut bacteria process fiber, the fiber breaks down into short chain fatty acids, which promote proper function of the cells lining the colon.⁶
• Incorporate leafy greens. Kale and spinach contain a particular sugar that helps fuel the growth of a healthy microbiome. Good fats, such as avocados and nuts, are fiber rich and nutrient dense. These fats contain potassium, which helps relay signals from the brain to the muscles of the GI tract.⁷
• Reduce sugar intake. A high-sugar diet can decrease the amount and function of good bacteria in the gut. High amounts of refined sugars can also cause increased sugar cravings, damaging the gut further. Reducing consumption of sugars, including high-fructose corn syrup, and processed foods can help maintain a healthy microbiome.²
• Steer clear of a high-fat diet. High-fat diets have been linked to negative changes in the diversity and quantity of gut bacteria. The quantity of unhelpful bacteria increases and the number of helpful bacteria decreases. The mechanism for this appears to be that the lack of fiber leaves helpful bacteria without food.⁸
• Chew food thoroughly. The digestive tract starts in the mouth. Teeth break food down into smaller pieces to allow for absorption of nutrients. Chewing produces saliva, which helps break down food and move it through the digestive tract.

CONCLUSION

It is normal to occasionally experience digestive issues. Bloating, constipation, gas, and heartburn are minor ailments that can disrupt life when they frequently occur. Additionally, subtle changes in the GI tract may be signs of significant illness.

A healthy GI tract promotes a healthy body and mind and provides a robust immune system. Keeping the gut healthy and rebalancing the gut flora after a disruption are topics that pharmacists can discuss with patients.

Kathleen Kenny, PharmD, RPh, has more than 25 years of experience as a community pharmacist and is a freelance clinical medical writer based in Colorado Springs, Colorado.

REFERENCES

1. Your digestive system & how it works. National Institute of Diabetes and Digestive and Kidney Diseases. Updated December 2017. Accessed September 11, 2021. https://www. niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

2. Dix M. What’s an unhealthy gut? How gut health affects you. Healthline. Updated August 25, 2020. Accessed September 12, 2021. https://www.healthline.com/health/gut-health

3. Stress effects on the body. American Psychological Association. November 1, 2018. Accessed September 12, 2021. https:// www.apa.org/topics/stress/body

4. Li Y, Hao Y, Fan F, Zhang B. The role of microbiome in insomnia, circadian disturbance and depression. Front Psychiatry. 2018;9:669. doi:10.3389/fpsyt.2018.00669

5. Quitting smoking could lead to major changes in gut bacteria. American Heart Association News. November 15, 2019. Accessed September 12, 2021. https://www.heart.org/ en/news/2019/11/15/quitting-smoking-could-lead-to-major-changes-in-gut-bacteria

6. 5 foods to improve your digestion. Johns Hopkins Medicine. Accessed September 13, 2021. https://www.hopkinsmedicine. org/health/wellness-and-prevention/5-foods-to-improve-your-digestion

7. Raman R. 8 signs and symptoms of potassium deficiency (hypokalemia). Healthline. March 7, 2018. Accessed September 13, 2021. https://www.healthline.com/nutrition/ potassium-deficiency-symptoms

8. Radcliffe S. What to know about high-fat diets and your microbiome. February 25, 2019. Accessed September 17, 2021. https://www.healthline.com/health-news/can-a-high-fat-diet-change-your-microbiome